,TEST BANK FOR STAHL'S ESSENTIAL PSYCHOPHARMACOLOGY:
g g g g g g
NEUROSCIENTIFIC BASIS AND PRACTICAL APPLICATIONS 4TH EDITION
g g g g g g g
Stahl's Essential Psychopharmacology g g
Neuroscientific Basis and Practical Applications TESTBANK/STUDY GUIDE g g g g g g
Chapter 1 Chemical neurotransmission
g g g
MULTIPLE CHOICE g
1. A patient with depression mentions to the nurse, My mother says depression is a
g g g g g g g g g g g g g
chemical disorder. What does she mean? The nurses response is based on the
g g g g g g g g g g g g g
theorythat depression primarily involves which of the following
g g g g g g g g
neurotransmitters?
a. Cortisol and GABA g g
b. COMT and glutamate g g
c. Monamine and glycine g g
d. Serotonin and norepinephrine g g
ANS: D g
One possible cause of depression is thought to involve one or more
g g g g g g g g g g g
neurotransmitters.Serotonin and norepinephrine have been found to be important
g g g g g g g g g
in the regulation of depression. There is no research to support that the other
g g g g g g g g g g g g g g
options play a significant role in the development of depression.
g g g g g g g g g g
2. A patient has experienced a stroke (cerebral vascular accident) that has
g g g g g g g g g g
resulted in damage to the Broca area. Which evaluation does the nurse conduct to
g g g g g g g g g g g g g g
reinforce thisdiagnosis?
g g
a. Observing the patient pick up a spoon g g g g g g
b. Asking the patient to recite the alphabet g g g g g g
c. Monitoring the patients blood pressure g g g g
d. Comparing the patients grip strength in both hands g g g g g g g
ANS: B g
Accidents or strokes that damage Brocas area may result in the inability to speak
g g g g g g g g g g g g g
(i.e., motor aphasia). Fine motor skills, blood pressure control, and muscle strength
g g g g g g g g g g g g
are notcontrolled by the Broca area of the left frontal lobe.
g g g g g g g g g g g
3. The patient diagnosed with schizophrenia asks why psychotropic medications
g g g g g g g g
are always prescribed by the doctor. The nurses answer will be based on
g g g g g g g g g g g g g
information thatthe therapeutic action of psychotropic drugs is the result of their
g g g g g g g g g g g g
effect on:
g g
a. The temporal lobe; especially Wernickes area
g g g g g
b. Dendrites and their ability to transmit electrical impulses g g g g g g g
c. The regulation of neurotransmitters especially dopamine
g g g g g
d. The peripheral nervous system sensitivity to the psychotropic medications
g g g g g g g g
,ANS: C g
Medications used to treat psychiatric disorders operate in and around the synaptic
g g g g g g g g g g g
cleftand have action at the neurotransmitter level, especially in the case of
g g g g g g g g g g g g
schizophrenia, on dopamine. The Wernickes area, dendrite function, or the
g g g g g g g g g g
sensitivity of the peripheral nervous system are not relevant to either schizophrenia
g g g g g g g g g g g g
or psychotropic medications.
g g g
4. A student nurse mutters that it seems entirely unnecessary to have to struggle
g g g g g g g g g g g g
withunderstanding the anatomy and physiology of the neurologic system. The
g g g g g g g g g g
mentor would base a response on the understanding that it is:
g g g g g g g g g g g
Necessary but generally for psychiatric nurses who focus primarily g g g g g g g g
a. onbehavioral interventions
g g
A complex undertaking that advance practice psychiatric nurses frequently
g g g g g g g g
b. usein their practiceg g g
Important primarily for the nursing assessment of patients with g g g g g g g g
c. braintraumacaused cognitive symptoms
g g g
Necessary for planning psychiatric care for all patients especially g g g g g g g g
d. thoseexperiencing psychiatric disorders
g g g
ANS: D g
Nurses must understand that many symptoms of psychiatric disorders have a
g g g g g g g g g g
neurologic basis, although the symptoms are manifested behaviorally. This
g g g g g g g g g
understanding facilitates effective care planning. The foundation of knowledge is
g g g g g g g g g g
notused exclusively by advanced practice psychiatric nurses nor is it relevant for
g g g g g g g g g g g g
only behavior therapies or brain trauma since dealing with the results of normal
g g g g g g g g g g g g g
and abnormal brain function is a responsibility of all nurses providing all types of
g g g g g g g g g g g g g g
care tothe psychiatric patient.
g g g g
5. A patient asks the nurse, My wife has breast cancer. Could it be caused by
g g g g g g g g g g g g g g
herchronic depression? Which response is supported by research data?
g g g g g g g g g
a. Too much stress has been proven to cause all kinds of cancer.
g g g g g g g g g g g
b. There have been no research studies done on stress and disease yet.
g g g g g g g g g g g
c. Stress does cause the release of factors that suppress the immune system.
g g g g g g g g g g g
d. There appears to be little connection between stress and diseases of the body
g g g g g g g g g g g g
ANS: C g
Research indicates that stress causes a release of corticotropin-releasing factors
g g g g g g g g g
that suppress the immune system. Studies indicate that psychiatric disorders such
g g g g g g g g g g g
as mooddisorders are sometimes associated with decreased functioning of the
g g g g g g g g g g
immune system.Research does not support a connection between many cancers
g g g g g g g g g g
and stress. There is a significant amount of research about stress and the body.
g g g g g g g g g g g g g g
Research has shown that there are some connections between stress and physical
g g g g g g g g g g g
disease.
g
, 6. A patient who has a parietal lobe injury is being evaluated for psychiatric
g g g g g g g g g g g g
rehabilitation needs. Of the aspects of functioning listed, which will the nurse
g g g g g g g g g g g g
identifyas a focus of nursing intervention?
g g g g g g
a. Expression of emotion g g
b. Detecting auditory stimuli g g
c. Receiving visual images g g
d. Processing associations g
ANS: D g
The parietal lobe is responsible for associating and processing sensory information
g g g g g g g g g g
that allows for functions such as following directions on a map, reading a clock,
g g g g g g g g g g g g g g
dressing self, keeping appointments, and distinguishing right from left. Emotional
g g g g g g g g g g
expression is associated with frontal lobe function. Detecting auditory stimuli is a
g g g g g g g g g g g g
temporal lobe function. Receiving visual images is related to occipital lobe
g g g g g g g g g g g
function.
g
7. At admission, the nurse learns that some time ago the patient had an infarct in
g g g g g g g g g g g g g g
theright cerebral cortex. During assessment, the nurse would expect to find that
g g g g g g g g g g g g
the patient:
g g
a. Demonstrates major deficiencies in speech g g g g
b. Is unable to effectively hold a spoon in the left hand
g g g g g g g g g g
c. Has difficulty explaining how to go about using the telephone
g g g g g g g g g
d. Cannot use his right hand to shave himself or comb his own hair g g g g g g g g g g g g
ANS: B g
The cerebral hemispheres are responsible for functions such as control of muscles.
g g g g g g g g g g g
The right hemisphere mainly controls the motor and sensory functions on the left
g g g g g g g g g g g g g
sideof the body. Damage to the right side would result in impaired function on the
g g g g g g g g g g g g g g g
left side of the body. The motor cortex controls voluntary motor activity. Brocas
g g g g g g g g g g g g g
area controls motor speech. Cognitive functions are attributed to the association
g g g g g g g g g g g
cortex.
g
The right side of the bodys motor activity is controlled by the left cerebral cortex.
g g g g g g g g g g g g g g
8. A patient with chronic schizophrenia had a stroke involving the hippocampus.
g g g g g g g g g g
Thepatient will be discharged on low doses of haloperidol. The nurse will need to
g g g g g g g g g g g g g g
individualize the patients medication teaching by:
g g g g g g
a. Including the patients caregiver in the education g g g g g g
b. Being careful to stress the importance of taking the medication as prescribed
g g g g g g g g g g g
Providing the education at a time when the patient is emotionally calm
g g g g g g g g g g g
c. andrelaxed
g
Encouraging the patient to crush or dissolve the medication to help g g g g g g g g g g
d. withswallowing
g
ANS: A g
g g g g g g
NEUROSCIENTIFIC BASIS AND PRACTICAL APPLICATIONS 4TH EDITION
g g g g g g g
Stahl's Essential Psychopharmacology g g
Neuroscientific Basis and Practical Applications TESTBANK/STUDY GUIDE g g g g g g
Chapter 1 Chemical neurotransmission
g g g
MULTIPLE CHOICE g
1. A patient with depression mentions to the nurse, My mother says depression is a
g g g g g g g g g g g g g
chemical disorder. What does she mean? The nurses response is based on the
g g g g g g g g g g g g g
theorythat depression primarily involves which of the following
g g g g g g g g
neurotransmitters?
a. Cortisol and GABA g g
b. COMT and glutamate g g
c. Monamine and glycine g g
d. Serotonin and norepinephrine g g
ANS: D g
One possible cause of depression is thought to involve one or more
g g g g g g g g g g g
neurotransmitters.Serotonin and norepinephrine have been found to be important
g g g g g g g g g
in the regulation of depression. There is no research to support that the other
g g g g g g g g g g g g g g
options play a significant role in the development of depression.
g g g g g g g g g g
2. A patient has experienced a stroke (cerebral vascular accident) that has
g g g g g g g g g g
resulted in damage to the Broca area. Which evaluation does the nurse conduct to
g g g g g g g g g g g g g g
reinforce thisdiagnosis?
g g
a. Observing the patient pick up a spoon g g g g g g
b. Asking the patient to recite the alphabet g g g g g g
c. Monitoring the patients blood pressure g g g g
d. Comparing the patients grip strength in both hands g g g g g g g
ANS: B g
Accidents or strokes that damage Brocas area may result in the inability to speak
g g g g g g g g g g g g g
(i.e., motor aphasia). Fine motor skills, blood pressure control, and muscle strength
g g g g g g g g g g g g
are notcontrolled by the Broca area of the left frontal lobe.
g g g g g g g g g g g
3. The patient diagnosed with schizophrenia asks why psychotropic medications
g g g g g g g g
are always prescribed by the doctor. The nurses answer will be based on
g g g g g g g g g g g g g
information thatthe therapeutic action of psychotropic drugs is the result of their
g g g g g g g g g g g g
effect on:
g g
a. The temporal lobe; especially Wernickes area
g g g g g
b. Dendrites and their ability to transmit electrical impulses g g g g g g g
c. The regulation of neurotransmitters especially dopamine
g g g g g
d. The peripheral nervous system sensitivity to the psychotropic medications
g g g g g g g g
,ANS: C g
Medications used to treat psychiatric disorders operate in and around the synaptic
g g g g g g g g g g g
cleftand have action at the neurotransmitter level, especially in the case of
g g g g g g g g g g g g
schizophrenia, on dopamine. The Wernickes area, dendrite function, or the
g g g g g g g g g g
sensitivity of the peripheral nervous system are not relevant to either schizophrenia
g g g g g g g g g g g g
or psychotropic medications.
g g g
4. A student nurse mutters that it seems entirely unnecessary to have to struggle
g g g g g g g g g g g g
withunderstanding the anatomy and physiology of the neurologic system. The
g g g g g g g g g g
mentor would base a response on the understanding that it is:
g g g g g g g g g g g
Necessary but generally for psychiatric nurses who focus primarily g g g g g g g g
a. onbehavioral interventions
g g
A complex undertaking that advance practice psychiatric nurses frequently
g g g g g g g g
b. usein their practiceg g g
Important primarily for the nursing assessment of patients with g g g g g g g g
c. braintraumacaused cognitive symptoms
g g g
Necessary for planning psychiatric care for all patients especially g g g g g g g g
d. thoseexperiencing psychiatric disorders
g g g
ANS: D g
Nurses must understand that many symptoms of psychiatric disorders have a
g g g g g g g g g g
neurologic basis, although the symptoms are manifested behaviorally. This
g g g g g g g g g
understanding facilitates effective care planning. The foundation of knowledge is
g g g g g g g g g g
notused exclusively by advanced practice psychiatric nurses nor is it relevant for
g g g g g g g g g g g g
only behavior therapies or brain trauma since dealing with the results of normal
g g g g g g g g g g g g g
and abnormal brain function is a responsibility of all nurses providing all types of
g g g g g g g g g g g g g g
care tothe psychiatric patient.
g g g g
5. A patient asks the nurse, My wife has breast cancer. Could it be caused by
g g g g g g g g g g g g g g
herchronic depression? Which response is supported by research data?
g g g g g g g g g
a. Too much stress has been proven to cause all kinds of cancer.
g g g g g g g g g g g
b. There have been no research studies done on stress and disease yet.
g g g g g g g g g g g
c. Stress does cause the release of factors that suppress the immune system.
g g g g g g g g g g g
d. There appears to be little connection between stress and diseases of the body
g g g g g g g g g g g g
ANS: C g
Research indicates that stress causes a release of corticotropin-releasing factors
g g g g g g g g g
that suppress the immune system. Studies indicate that psychiatric disorders such
g g g g g g g g g g g
as mooddisorders are sometimes associated with decreased functioning of the
g g g g g g g g g g
immune system.Research does not support a connection between many cancers
g g g g g g g g g g
and stress. There is a significant amount of research about stress and the body.
g g g g g g g g g g g g g g
Research has shown that there are some connections between stress and physical
g g g g g g g g g g g
disease.
g
, 6. A patient who has a parietal lobe injury is being evaluated for psychiatric
g g g g g g g g g g g g
rehabilitation needs. Of the aspects of functioning listed, which will the nurse
g g g g g g g g g g g g
identifyas a focus of nursing intervention?
g g g g g g
a. Expression of emotion g g
b. Detecting auditory stimuli g g
c. Receiving visual images g g
d. Processing associations g
ANS: D g
The parietal lobe is responsible for associating and processing sensory information
g g g g g g g g g g
that allows for functions such as following directions on a map, reading a clock,
g g g g g g g g g g g g g g
dressing self, keeping appointments, and distinguishing right from left. Emotional
g g g g g g g g g g
expression is associated with frontal lobe function. Detecting auditory stimuli is a
g g g g g g g g g g g g
temporal lobe function. Receiving visual images is related to occipital lobe
g g g g g g g g g g g
function.
g
7. At admission, the nurse learns that some time ago the patient had an infarct in
g g g g g g g g g g g g g g
theright cerebral cortex. During assessment, the nurse would expect to find that
g g g g g g g g g g g g
the patient:
g g
a. Demonstrates major deficiencies in speech g g g g
b. Is unable to effectively hold a spoon in the left hand
g g g g g g g g g g
c. Has difficulty explaining how to go about using the telephone
g g g g g g g g g
d. Cannot use his right hand to shave himself or comb his own hair g g g g g g g g g g g g
ANS: B g
The cerebral hemispheres are responsible for functions such as control of muscles.
g g g g g g g g g g g
The right hemisphere mainly controls the motor and sensory functions on the left
g g g g g g g g g g g g g
sideof the body. Damage to the right side would result in impaired function on the
g g g g g g g g g g g g g g g
left side of the body. The motor cortex controls voluntary motor activity. Brocas
g g g g g g g g g g g g g
area controls motor speech. Cognitive functions are attributed to the association
g g g g g g g g g g g
cortex.
g
The right side of the bodys motor activity is controlled by the left cerebral cortex.
g g g g g g g g g g g g g g
8. A patient with chronic schizophrenia had a stroke involving the hippocampus.
g g g g g g g g g g
Thepatient will be discharged on low doses of haloperidol. The nurse will need to
g g g g g g g g g g g g g g
individualize the patients medication teaching by:
g g g g g g
a. Including the patients caregiver in the education g g g g g g
b. Being careful to stress the importance of taking the medication as prescribed
g g g g g g g g g g g
Providing the education at a time when the patient is emotionally calm
g g g g g g g g g g g
c. andrelaxed
g
Encouraging the patient to crush or dissolve the medication to help g g g g g g g g g g
d. withswallowing
g
ANS: A g
